AB1030 PATIENT CARE AT THE FRACTURE LIAISON SERVICE REDUCE THE GAP IN THE TREATMENT OF OSTEOPOROSIS BETWEEN MEN AND WOMEN.
Authors: B. Hernández-Cruz, M. J. Miranda García, J. Barrera, F. J. Olmo Montes, M. A. Vázquez Gómez, M. Giner García, M. A. Colmenero Camacho, J. J. Pérez Venegas, M. J. Montoya García
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoporosis (OP) between men and women is different,and the way it is treated also differs. In men, the gap in clinical care, especially diagnosis and treatment, is worse. Objectives To analyze the differences in the clinical characteristics of OP (demographics, comorbidities, diagnosis, and treatment) in an gold star Fracture Liaison Service (FLS). Methods Design: Observational, prospective, analytical study of usual clinical practice. All patients treated from an FLS from May 2018 to August 2021 were prospectively included. Of each patient, 160 clinical variables were introduced in a real time database, and they were followed for 2 years. Results 557 patients were analyzed, 472 (83%) women and 100 (17%) men. The main features are summarized in the table. In women the vertebral fracture predominated followed by the hip fracture, in men the hip followed by the vertebral ones. Men had higher rates of smoking and alcoholism. The frequency of secondary OP and exercise was different between sexes. Weight, height, and BMI were different, due to different body composition. The frequency of specific treatment for OP (bisphosphonate, denosumab, teripatide, SERM) before fracture was very low, lower in men. The most remarkable result was the low percentage of patients with OP receiving treatment before the FLS, and the differences between sex; 77 (16%) women versus 6 (6%) men had received it at some point in their lives, p=0.008. The probability of a man not receiving prior treatment was 2. 70 (95%CI 1.13- 7.81); p=0,008. After the FLS all the patients were treated. Treatment adherence in the first two years after the FLS was 84% in both sexes. Conclusion OP is different between women and men. The probability of not receiving treatment in men was higher among men, these differences disappeared after care in FLS. Table 1 Variable Hipn, %239, 43 Vertebraln, %159, 28 DERn, %96, 17 Humerusn, % 41, 7 Othern, % 37, 6 p Women Men Women Men Women Men Women Men Women Men 0.0001 Number 179, 75 60, 25 129, 81 30, 19 93, 97 3, 3 40, 98 1, 2 31, 84 6, 16 0.06 Current smoker 13, 8 * 19, 32 20, 16 * 14, 48 16, 17 * 1, 33 3, 8 0, 0 8, 1 0.3 Drinker &gt;3 cups/day 5, 3 * 14, 24 9, 7 * 11, 38 6, 6 1, 33 2, 5 0, 0 2, 6 0 0.001 Secondary causes of OP 24, 16 10, 21 24, 22 14, 56 14, 18 0, 0 11, 32 0, 0 9, 32 1, 20 0,03 Exercise 0,0001 Bed to armchair 35, 28 * 12, 21 10, 8* 8, 28 1, 1 0, 0 3, 8 1, 3* 2, 33 Wanders at home 64, 0 13, 23 36, 30* 5, 17 7, 8 0, 0 5, 13 11, 38 1, 17 Walk in the street 58, 36 26, 46 53, 43 15, 52 59, 68 2, 67 25, 64 10, 34 3, 50 Daily exercise 4, 2 5, 9 22, 18 1, 3 20, 23 6, 15 7, 24 0, 0 Total 161, 74 56, 26 121, 81 29, 19 87, 97 1, 33 3, 3 39, 100 29, 82 6, 17 BMI ≥ 30 53, 32 14, 25 51, 43 13, 46 38, 43* 3, 7 17, 45 1, 5 9, 29 2, 40 0.01 OP treatment before FF 26, 15 * 2, 3 28, 23 * 3, 10 * 13, 15 0, 0 6, 16 0, 0 4, 14 1, 20 0,008 Re-fracture (one year) 11, 9 4, 8 6, 7 0, 0 5, 8 0, 0 2, 8 1, 100 0, 0 0, 0 0.9 Mean± SD Mean ± SD Mean ± SD Mean ± SD Mean ± SD Mean± SD Mean ± SD Mean ± SD Mean± SD Mean± SD Age, Years 79±8.7* 75.5 ±10.3 70.4±9.0 69.3±10.0 69±9.2 73.6±6.5 71.3± 8.7* 76 68.6±11.3 82.6±8.3 0.6 Weight, Kg 65.3±14,3* 72.1±12.9 67.2±13.4 78.5±14.9 70.7±12.1 85.5±13.4 71.7±11.8 90 68.6±18.6* 77.7±19.4 0.00001 Size, m 1.5±0.06* 1.64±0.06 1.51±0.01 1.63±0.06 1.54±0.06 1.6±0.06 1.54 ±0.06 1,63 1.54±0.06* 1.61±0.09 0.00001 BMI 28.4 ±5.1* 26.7±4.1 29.2 ±6.3 29.1±4.8 29.9±5.4 33.2±2.6 30.1±4.9 33.8 28.9±6.7 29.4± 6.2 0,04 DER= distal end of radius, Others included ribs, tibia and fibula, distal end of femur. BMI Body mass index. *p value between women and men in each group of fragility fractures. Disclosure of Interests Blanca Hernández-Cruz Speakers bureau: Abbvie, Lilly, Stada, UCB, GebroPharma, Nordic, Consultant of: Abbvie, MSD, Lilly, Stada, UCB, Maria José Miranda García: None declared, Julia Barrera: None declared, Francisco Jesús Olmo Montes: None declared, María Angeles Vázquez Gómez: None declared, Mercedes Giner García: None declared, Miguel Angel Colmenero Camacho: None declared, José Javier Pérez Venegas: None declared, María José Montoya García: None declared